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Hyperhidrosis: Current Understanding, Current Therapy

Authors: Authors: Markus Naumann, MD; Jonathan R.T. Davidson, MD; Dee Anna Glaser, MDFaculty and Disclosures


Preface: The Patient's Perspective

Lisa dates her problem with hyperhidrosis to her sophomore year of high school. It probably started a bit earlier, she thinks, but a humiliating experience during her Oral Communications class marks the symbolic beginning of her struggle with hyperhidrosis. After literally sweating through an oral presentation in front of the class, she heard a fellow student mutter in disgust, "Oh my God, look at her. Look at how bad she's sweating." Lisa still finds the memory painful.

Being a 15-year-old girl is tough, but being a 15-year-old girl with hyperhidrosis is tougher. The fun of being a cheerleader was overshadowed by the turmoil of constantly worrying about how much she was sweating. She worked up the courage to tell her parents, but they didn't really understand. "I didn't even know that prescription antiperspirants existed, and I was too young to take the situation into my own hands," she remembers today at age 26. So she changed clothes 3 times a day, stuffed tissues, napkins, and paper towels in her armpits, and blamed herself. And that's how she coped with hyperhidrosis for the next 8 years.

A newsmagazine show was on the TV, but Lisa wasn't paying much attention. Then she realized that the woman being interviewed was talking about her constant battle with sweating. "My head just spun around," remembers Lisa. "I thought it was just me, and so I blamed myself. Then I saw this woman on TV and I realized, I'm not the only one."

And so at age 23 Lisa worked up the courage to see a doctor. He prescribed an antiperspirant, but it didn't help. Three months later, she went to a different doctor and got a prescription for a different antiperspirant, but it didn't help either. For the next 3 years, Lisa continued to perfect her routine for dealing with hyperhidrosis:

"I can't buy nice clothes, because I have to throw them away after wearing them once or twice, especially white things. I probably spend 2 hours a day dealing with sweating -- wiping, refreshening, showering, bathing, washing clothes -- but I really spend more time than that because I never stop thinking about it. When I go to a club with my friends, the first thing I do is check out the bathroom. Are there plenty of paper towels for me to stuff in my armpits? Is there an air-dryer I can use to dry my armpits? I don't take off my coat when I make presentations, and I never gesture with my hands -- people would see the sweat stains that go halfway down my arms, or, even worse, the paper towels might fall out. I always keep my arms held close to my body. When I visit friends or relatives, I make sure I hug everyone before I take off my coat."

Of course developing personal relationships has been difficult. Lisa has told only her parents -- who now understand the condition and are supportive -- and her boyfriend. But a favor Lisa recently did for her mother may hold the solution to her problem. Lisa's mother had an appointment with a dermatologist, and Lisa gave her a ride and sat in on the consultation. At the end of the appointment, Lisa asked about sweating. The dermatologist turned out to be a recognized expert in hyperhidrosis, and Lisa will begin treatment soon.